Perioperative Nursing Care, Pre-op to Post-op Safety, and Complication Prevention | Chapter 16 from Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition)

Perioperative Nursing Care, Pre-op to Post-op Safety, and Complication Prevention | Chapter 16 from Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition)

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Welcome to Chapter 16 of the Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri. This essential chapter guides you through the perioperative process—from preoperative preparation and legal responsibilities, through intraoperative safety, to vigilant postoperative care and complication management. Whether you’re a nursing student or prepping for the NCLEX-PN, these foundational concepts are crucial for safe, evidence-based practice.

Watch the full chapter video summary below, and subscribe to Last Minute Lecture for more NCLEX-PN chapter breakdowns and real-world nursing tips:

Preoperative Nursing Responsibilities

  • Informed Consent: Ensure proper documentation, legal signature, and client understanding—witness but do not obtain consent for provider procedures.
  • NPO Status and Pre-op Prep: Maintain fasting guidelines, verify allergy bands, remove jewelry/valuables, and perform skin prep as indicated.
  • Pre-op Education: Teach about breathing/leg exercises, pain management, incentive spirometer, and use of SCDs or TED hose for DVT prevention.
  • Psychosocial Support: Address fears, cultural needs, and use effective communication for holistic care.
  • Safety Checklists: Complete pre-op checklists, confirm surgical site (time-out), and verify ID bands.

Intraoperative and Immediate Postoperative Care

  • Monitoring: Continuous assessment of airway, breathing, and circulation—use of pulse oximetry, ECG, and frequent vitals.
  • Pain Management: Use both pharmacologic (opioids, PCA pumps) and nonpharmacologic strategies.
  • Mobility and Positioning: Prevent pressure injuries, encourage movement as tolerated, and use assistive devices.
  • Prevention of Complications: Maintain sterile technique, monitor drains/catheters, and observe for bleeding or infection.

Postoperative Assessment and Complication Prevention

  • Respiratory: Monitor for pneumonia, atelectasis, hypoxemia; encourage coughing, deep breathing, and use of incentive spirometer.
  • Cardiovascular: Watch for shock, hemorrhage, DVT—monitor pulse, BP, and calf tenderness or swelling.
  • Gastrointestinal: Assess bowel sounds, monitor for ileus, constipation, or nausea; manage NG tubes as ordered.
  • Renal: Track urine output for signs of retention or dehydration.
  • Integumentary/Wound Care: Inspect for drainage, redness, dehiscence, or evisceration; reinforce wound support and dressing changes as needed.
  • Neurological/Temperature: Monitor LOC and body temperature for early signs of complications.

Emergency Interventions and Client Teaching

  • Hemorrhage/Shock: Identify early signs—low BP, tachycardia, pallor, cold/clammy skin; initiate rapid response and follow facility protocols.
  • Wound Dehiscence/Evisceration: Cover with sterile saline-soaked gauze, notify provider, maintain client in low Fowler’s position, and prepare for emergency intervention.
  • Discharge Planning: Educate on wound care, pain control, mobility, dietary needs, and signs to report after ambulatory surgery.

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Conclusion: Confident, Holistic Perioperative Nursing Care

Chapter 16 of Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition) prepares you to deliver safe, effective, and culturally sensitive perioperative care. From client education and legal documentation to vigilant monitoring for post-op complications, you’ll be equipped for every step of the surgical journey—both on the exam and in practice.

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